Ma ke ʻano he makuahine e hiki mai ana, he mea waiwai kēlā me kēia neʻe ʻana o kāu pēpē i loko o kou ʻōpū, kēlā me kēia kiʻi āu e ʻike ai ma kahi scan. Akā i kekahi manawa, ke nānā ke kauka i kahi scan a ʻōlelo, "Me he mea lā he pilikia iki ko ka pēpē," he paʻakikī ke hōʻike i ka makaʻu a me ka hopohopo āu e manaʻo ai. Akā, mai hopohopo. I kēia lā, ua holomua loa ka lāʻau lapaʻau . Hiki ke mālama ʻia kekahi mau kīnā hānau a me nā kūlana olakino ma mua o ka hiki ʻana mai o ka pēpē i kēia ao, ʻo ia hoʻi, i loko o kou ʻōpū. ʻO kēlā kaʻina hana lapaʻau kupaianaha ka mea a mākou e kapa nei he "Fetal Surgery." E kamaʻilio maʻalahi kākou e pili ana i kēia.
He aha ke ʻoki kino ʻana o ka pēpē?
I ka ʻōlelo maʻalahi, ʻo ke ʻoki ʻana o ka fetal he ʻoki ʻana i hana ʻia ma kāu pēpē i kona wā i loko o ka ʻōpū. Kapa pū kekahi poʻe iā ia he 'ʻoki ʻana i loko o ka ʻōpū' a i ʻole 'ʻoki ʻana i ka wā hānau'.
E noʻonoʻo, inā he kīnā hānau ko kahi pēpē, hiki i kēlā kīnā ke ʻoi aku ka ʻino i kona ulu ʻana i loko o ka ʻōpū. Akā ma o kēia ʻano hana, hiki i kahi hui o nā loea ke mālama i ka hemahema ma mua o ka hānau ʻana o ka pēpē a hōʻemi i kona hopena. I kekahi manawa he mea pono kēia e hoʻopakele i ke ola o ka pēpē a hoʻomaikaʻi i kona olakino i ka wā e hiki mai ana. I nā hihia ʻoi aku ka liʻiliʻi o ka ʻino , kapa pū nā kauka i kēia "fetal intervention."
Ma muli o ke kūlana o ka pēpē, hiki ke hana ʻia kēia mau ʻokiʻoki i ka wā mua o 16 mau pule. Eia nō naʻe, hana pinepine ʻia nā ʻokiʻoki paʻakikī ma waena o 22 a me 26 mau pule o ka hāpai ʻana.
No ke aha ʻoe e pono ai e hana i kēia ʻano ʻoki kino?
ʻO ka pahuhopu nui o kēia, ʻo ia ke kōkua i ka pēpē e ulu olakino. Hiki i kekahi mau kīnā hānau ke hoʻoweliweli i ke ola. ʻO kekahi, ʻoiai ʻaʻole ia he mea hoʻoweliweli i ke ola, hiki ke hoʻoulu i ka pēpē i kekahi kīnā ma hope o ka hānau ʻana.
ʻO ka maʻamau, mālama ʻia kēia ʻano maʻi ma hope o ka hānau ʻana o ka pēpē. Eia nō naʻe, aia kekahi mau kūlana kahi e ʻoi aku ka maikaʻi o nā hopena inā mālama ʻia ʻoiai ke pēpē i loko o ka ʻōpū. ʻO ka mālama ʻana iā lākou i ka wā mua hiki ke hōʻemi i ka hōʻino ʻana i nā ʻōpū o ka pēpē a kōkua iā lākou e noho olakino i ka wā lōʻihi.
He kahua kūikawā loa kēia. Hoʻoholo ʻia ka hoʻoholo ʻana e hana i ia ʻano ʻoki kino inā ua maopopo i nā kauka ʻaʻohe koho ʻē aʻe a he mea nui loa ia no ka wā e hiki mai ana o ka pēpē.
He aha ke ʻano o ka hui loea e hana nei i kēia mau ʻoki kino?
ʻAʻole loa kēia he mea i hana ʻia e kekahi kanaka. Pono ia i kahi hui o nā loea i aʻo nui ʻia, multidisciplinary. ʻO ka maʻamau, aia i loko o ka hui:
- Nā loea i ka lāʻau lapaʻau makuahine a me ka pēpē (nā loea lapaʻau makuahine-kōpio ): Nā kauka nāna e mālama pono i ke olakino o ka makuahine a me ka pēpē.
- Nā kauka lapaʻau keiki: Nā kauka i loea i ke ʻoki ʻana i nā pēpē.
- Nā anesthesiologists makuahine a me nā keiki: Hoʻokele pono lākou i ka anesthesia i ka makuahine a me ka pēpē i ka wā o ke ʻoki ʻana.
- Nā Kauka Puʻuwai Fetal: Nā loea e nānā i nā pilikia me ka puʻuwai o ka pēpē.
- Nā loea kiʻi ʻana o ka pēpē: ʻO ka poʻe e nānā pono ana i ke kūlana o ka pēpē me ka hoʻohana ʻana i nā mīkini scan o kēia au loa.
- Nā kauka ʻoki ʻē aʻe e kūpono i nā pono o ka pēpē.
He aha nā kūlana nui i mālama ʻia me kēia mau ʻoki kino?
Aia kekahi mau kūlana e hiki ke mālama ʻia me ke ʻoki ʻana o ka fetal . Hōʻike ka papa ma lalo nei i kekahi o lākou a me kahi wehewehe maʻalahi o lākou.
| Kūlana | He wehewehe maʻalahi |
|---|---|
| Spine Bifida | Ua hāmama ka iwi kuamoʻo a me ke kaula kuamoʻo o ke pēpē me ka ʻole o ka pani pono ʻana. |
| ʻO ka maʻi hoʻoili māhoe-a-māhoe (TTTS) | Ka like ʻole o ke kahe koko o ka placenta ma waena o nā māhoe. Loaʻa i kekahi pēpē ka nui o ke koko a ʻo kekahi ka liʻiliʻi. |
| ʻO ka Hernia Diaphragmatic Congenital (CDH) | He lua ma ka diaphragm e hoʻokaʻawale ana i ka umauma a me ka ʻōpū, e puka mai ana nā ʻōpū i loko o ka umauma. |
| ʻO ka Teratoma Sacrococcygeal (SCT) | He puʻupuʻu e hana ʻia ana ma ka wahi haʻahaʻa loa o ka iwi kuamoʻo o ka pēpē (ma ka ʻāpana puʻupuʻu). |
| Ka Pale ʻana o ke Ala Mimi Haʻahaʻa (LUTO) | ʻO ka paʻa ʻana o ke ala mimi o ka pēpē e hiki ai ke hoʻonui i ka ʻōpū mimi a hōʻino i nā puʻupaʻa. |
He aha nā ʻano hana e hana ai i ke ʻoki kino?
Ma muli o kou olakino a me ke olakino o kāu pēpē, e koho ke kauka lapaʻau i ke ʻano kūpono loa. ʻEkolu mau ʻano nui.
1. ʻO ke ʻoki kino Fetoscopic
Ua like kēia me ke "ʻoki puka kī." Hoʻokomo ke kauka i kahi kāmela liʻiliʻi (fetoscope) a me nā mea hana ʻoki ma o kahi ʻoki liʻiliʻi loa i loko o kou ʻōpū. Hoʻemi kēia i ka ʻeha a hoʻopōkole i ka manawa ho'ōla.
2. ʻOki Hana Hāmama
Ma kēia, e hāʻawi ʻia ʻoe i ka anesthesia laulā. A laila, e ʻoki ke kauka lapaʻau i kou ʻōpū a me ka uterus a hele i kahi o ka pēpē. ʻO ka mea nui, e noho ka pēpē i loko o ka uterus i ka wā o ke ʻoki ʻana. Ma hope o ke ʻoki ʻana, e pani pono ʻia ka uterus a me ka ʻōpū, a e hoʻomau ka hāpai ʻana e like me ka maʻamau.
3. Nā ʻokiʻoki i hana ʻia i ka wā hānau keiki (Nā Kaʻina Hana EXIT)
He hana kūikawā loa kēia. Hana ʻia ke ʻoki ʻana i ka wā o ka ʻoki ʻoki cesarean. Hāʻawi ʻia ʻoe i ka anesthesia a hoʻomaha ʻia kou ʻōpū. A laila, wehe ʻia ka ʻōpū a ʻaʻole wehe loa ʻia ka pēpē, akā hapa. Ma mua o ka ʻoki ʻana i ke kaula umbilical, inā ua ālai ʻia ke ala ea o ka pēpē, hoʻoponopono ʻia, a i ʻole e wehe ʻia kekahi mea e like me ka puʻupuʻu nui. Ma hope wale nō o ka paʻa ʻana o ka pēpē, ʻoki ʻia ke kaula umbilical a hānau piha ʻia ka pēpē.
He aha nā pilikia o kēia ʻano hana ʻoki kino?
E like me nā ʻoki kino āpau, loaʻa i ke ʻoki kino fetal kekahi mau pilikia. Hiki i kēia mau pilikia ke hoʻopilikia i ka makuahine a me ke pēpē. He mea nui e wehe a hoʻomaopopo e pili ana iā lākou.
| Nā pilikia o ke ʻoki kino | |
|---|---|
| Nā pilikia i ka makuahine | |
| • | Pono e hānau ʻia kēia keiki a me nā keiki e hiki mai ana ma o ka ʻoki caesarean. |
| • | Pono e hāʻawi koko ma muli o ke kahe koko nui. |
| • | Hiki ke lahilahi a wehe hou paha ka ʻōpala o ka ʻōpū, kahi e hoʻoweliweli ai i nā hāpai ʻana i ka wā e hiki mai ana. |
| Nā pilikia hiki ke loaʻa i ka pēpē | |
| • | Hiki i ka placental abruption ke pale i ka pēpē mai ka loaʻa ʻana o ka meaʻai a lākou e pono ai. |
| • | Ka pilikia o ka hānau mua ʻana (ka hānau mua ʻana) ma muli o ke ʻoki kino. |
| • | ʻO Chorioamnionitis (kahi maʻi o ka wai amniotic) (he mea kākaʻikahi loa kēia). |
He mea paʻakikī loa ka hoʻoholo ʻana e pili ana i ia ʻano hana ʻoki kino. Pono ia e noʻonoʻo pono i ke olakino o ka makuahine a me ka pēpē. He mea nui e kūkākūkā pono i kēlā me kēia hoʻoholo me kāu hui lapaʻau.
Leka Lawe-Home
- He hana ʻoki kino kūikawā loa ke ʻoki ʻana o ka pēpē i mālama ʻia i nā kīnā hānau i loko o ka ʻōpū, ma mua o ka hānau ʻana o ke pēpē.
- ʻO ka pahuhopu nui ka hoʻopakele ʻana i ke ola o ke pēpē a me ka hoʻomaikaʻi ʻana i ko lākou olakino lōʻihi.
- ʻAʻole hana ʻia kēia e ke kauka hoʻokahi, akā, e kahi hui o nā loea lapaʻau i aʻo nui ʻia ma nā ʻano like ʻole.
- Aia kekahi mau ala e hana ai i ke ʻoki kino (puka kī, hāmama, a i ka wā hānau), a ʻo ke ʻano kūpono loa e hoʻoholo ʻia e nā kauka.
- E like me nā ʻoki kino āpau, aia nā pilikia no ka makuahine a me ka pēpē. No laila, pono e kūkākūkā pono ʻia nā hoʻoholo āpau me kāu kauka a me ka hui lapaʻau.
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